Acidity and heartburn medicine: a practical guide

Occasional symptoms may respond to an antacid or alginate, while recurrent acid reflux may require an acid-suppressing medicine and clinical review. Check the label, dose timing, interactions and treatment length with a pharmacist.

Heartburn is a burning sensation behind the breastbone caused when stomach contents move upwards into the food pipe. Acid reflux commonly presents with heartburn, sour fluid in the mouth, throat irritation or symptoms that worsen after meals, bending or lying down.

A hiatus hernia can present with reflux and heartburn because part of the stomach moves through the diaphragm. Gastritis and peptic ulcer more often present with upper-abdominal discomfort or burning. Obesity can increase pressure around the stomach and contribute to reflux. None of these conditions can be confirmed from burning alone.

Antacids neutralise existing acid and alginates create a floating barrier, so they can be useful for brief, occasional symptoms. Acid-suppressing medicines, including proton pump inhibitors and H2-receptor blockers, reduce acid production and have different onset and dosing instructions. More medicine is not automatically more effective.

Leave enough time between certain antacids and other tablets as directed, since absorption can be affected. Ask about suitability if you are pregnant, have kidney or liver problems, or take regular medicines. Alongside treatment, try smaller evening meals, remain upright after eating, and reduce only the foods, drinks or smoking habits that trigger your episodes.

Book a clinical review when heartburn occurs frequently, breaks through treatment, returns soon after a course, or is accompanied by food sticking, painful swallowing, persistent vomiting, unexplained weight loss, black stools, anaemia symptoms or ongoing upper-abdominal pain. A clinician can review medicines and decide whether testing is needed.

Call emergency services for new or severe chest pressure, especially with breathlessness, sweating, faintness, nausea, or pain spreading into an arm, the jaw or back. Also seek urgent care for vomiting blood, coffee-ground vomit or black sticky stools. Do not wait for heartburn medicine to relieve possible heart or bleeding symptoms.

Bring the names of products already tried and explain when symptoms appear in relation to food, sleep and exercise. Ask which medicine type matches that pattern, exactly when to take it, which other tablets need spacing, how to judge whether it worked, and what the next step is if burning returns.